LEAVE OF ABSENCE FORM by jhovyanne

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LEAVE OF ABSENCE FORM

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									Application Form for Leave of Absence
Please write legibly.

Date of Filing: ______________________ Applicant’s Name: _____________________________________________________ Surname First Name Middle Name Position: _____________________________________ Salary: _____________________________________ Office: ________________________________________________________________________ Type of Leave: ( ) Sick ( ) Vacation Inclusive Dates: _______________________________ Number of Days: _______________________________

__________________________ Signature Over Printed Name


								
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